Medicaid managed care success hinges on provider input, experts say

With the number of states adopting managed long-term services and supports programs rising, providers hoping to benefit must make their thoughts and concerns known to managed care stakeholders, experts stressed Monday.

Providers must stay engaged as Medicaid managed care becomes more prevalent, said Julie Weinberg, director of Medicaid policy at UnitedHealthcare Community and State, speaking during a session at LeadingAge's 2016 Annual Meeting & Expo. 

“You as providers, your voices are really important,” Weinberg said. “You need to show up, or have someone show up to every stakeholder meeting. If the health plans aren't successful, no one is successful. That is why the states and plans need your voices here.”

Providers also will benefit in a managed care world by facilitating care transitions from hospitals to post-acute care facilities, and facilities into the community. Currently, 41% of older adults requiring long-term supports are served in the community settings, up from 22% in 2002. But despite the push toward “less restrictive” home- and community-based settings, institutional long-term care providers should view Medicaid managed LTSS as an opportunity.

“There's always going to be a need for nursing facilities — you guys have bricks and mortar,” Weinberg said. “Even with a focus on getting people into the community, there are opportunities for facilities to be a partner for care.”

Other highlights from Monday's educational sessions at the convention included:

  • In the Housing Policy Forum update, Linda Couch, Director, Housing Policy & Priorities at LeadingAge, addressed the 2017 political scene, including relief on sequester caps and the low-income housing tax credit program. Hillary Clinton has talked frequently about the latter, plus a need to establish a larger infrastructure base and expand home ownership opportunities, Couch said. Donald Trump has not delved into affordable housing specifics but also discussed infrastructure and tax cuts to benefit citizens.

If the Senate flips to Democratic control, Sen. Chuck Schumer (D-NY) has said he'd tackle an infrastructure bill in the first 100 days, Couch noted.

Next year "I think we are going to see greater emphasis on human needs," Couch told McKnight's. "Patty Murray, Amy Klobuchar and other women in the Senate have shown a commitment to affordable housing."

  • In a session on reducing unnecessary medications, Denise Hyde, Community Builder, The Eden Alternative, and Frances Holliday of the Brookshire House Rehabilitation and Care in Denver, shared strategies for success. At the facility, psychotropic use dropped from 79% to 10% in less than a year. It is now 6%, Holliday shared.

Residents often benefit from being taken outdoors, she said. Other ways to engage residents and reduce agitation include hand massage with aromatherapy, pet therapy, playing music and giving a resident shower shoes or other amenities during bathing.

"Decreasing medication is not a scary thing and can be done easily," Holliday told McKnight's.

  • Meanwhile, during a session about contending with "The Infusion of Millennials into the Workforce," Linda Shell noted that in five years, 50% of the workforce will be millennials. That means new staffing strategies must be devised because the generation born roughly in the 1983-1997 range has attitudes and expectations of their bosses that will force seismic shifts unlike any before it.
  • They want fair and direct managers who are highly engaged in their personal development," Shell said. More than previous generations, millennials will value their "purpose" over just their paycheck; their development over satisfaction; and having a coach over having a boss, she added.

    "They're looking for mentors," noted co-speaker Wayne Olson, senior vice president of Volunteers of America Health Services, "and not just to help them in their job but to help them get their NEXT job."